Welcome to the Mpumalanga Provincial Government

Mpumalanga Department of Health Policy and Budget Speech for 2010/11 by Honourable MEC DG Mahlangu, Provincial Legislature

11 May 2010

Honourable Speaker
The Honourable Premier
Members of the Executive Council
Honourable members of the house
Esteemed guests
Leadership of Labour and Business
NGO sector
Head of Department Dr JJ Mahlangu, Management of the Department of Health and all its employees
Members of the media
People of Mpumalanga
Ladies and gentlemen.

It seems like just yesterday, but almost a year has already passed since we presented our 2009/10 Policy and Budget speech in this august house. This bears testimony to the importance of time as a feature of human existence. Indian philosophy contends that human nature owes its existence to the passage of time, and that it is time that defines our past, present and future. Time defines reality, which in turn is associated with present moment.

Honourable Speaker and Members, we presented our last Policy and Budget speech against harsh economic environment brought about by the global financial meltdown which had the potential to reverse all the gains we made in the last 16 years of freedom and democracy in advancing a better life for all South Africans. We are therefore delighted that we are witnessing signs of recovery in our economy. The skewed economic environment has adverse implications especially for the health sector as it pushes up our input costs especially with regard to acquisition of goods and services.

As we made this house aware in our last presentation, we entered 2009/10 financial year with an exorbitant amount in accruals that threatened our ability to deliver on our constitutional mandate and compliance to legal prescripts in respect to our obligations. It is with pleasure, and this is due to the major sacrifices made by all in the department, that I can now announce that we significantly reduced our accruals and we enter this New Year in a better financial situation.

This has taught us a valuable lesson that if as a collective we tighten our belts we can actually achieve more with the little we have. There has been a successful cut on unnecessary cost drivers and this in turn allows us to utilise the money on core services. We will continue even in this financial year to streamline our spending to focus on our core business. 

Honourable Speaker, Honourable members, the health sector has been struck by a tragic blow last month with the passing on of our Deputy Minister of Health Dr Molefi Paul Sefularo. He was indeed a gallant fighter and hero of our movement; a selfless servant of our people, a person who chose to service his people even when presented with opportunity to work elsewhere and earn more money.

His demeanour was always a shining example and real embodiment of the ideals and values of our fore bearers, who treasured service of the people as the ultimate goal. In his memory we shall move with haste to implement the National Health Insurance and host a successful world cup and deliver on all the guarantees Health sector made to FIFA. 

We must place it on record in this august house that we have made commendable progress with our preparations as far as our health guarantees are concerned. We are ready to deliver the best health-care service to the people who will visit our province during this event. Our areas of focus include amongst others; communicable disease control, port health services, Emergency Medical Services and malaria control.

More importantly for us is the legacy that will accrue to our province post the world cup in terms of health infrastructure.

Honourable Speaker, our focus in the last financial year was a concerted effort to achieve “greater efficiency” of our spending trends. We will strive to continue on this important effort and as I have already alluded above we have seen commendable progress in this regard.

We have been able to reduce our expenses on certain items by 20% to 80%. These items include but not limited to; venues and facilities were reduced by 60%; catering by 20%, office equipment by 76% and advertisement by 80%. This shows a clear commitment from the department to reduce non core expenditure and focus on the business at hand.

The second leg of this exercise will be to instil a more cost effective way of doing business with service providers among ourselves. We will achieve this by strengthening our procurement systems and ensuring that prices we are charged are market-related. I will convene a Service Providers’ Indaba so that we may endeavour to establish good working relationships that will benefit both parties.

I further outlined last year that the health department is faced with huge challenges in respect of Management and Leadership, inadequate systems and processes, poor infrastructure and technology, poor supply chain and contract management and inadequate staffing.

We have already started working on these areas and progress varies per challenge. We will, however, not take our eyes off the ball. We still believe that attending to these issues would solve more than 50% of our challenges thus enabling us to deliver on our mandate.

Service Transformation Plan

Honourable Speaker it is regrettable that we have not been able to complete this important aspect of our work. However, it remains essential for the province to decide on the delivery health package model and platform because this informs our funding, infrastructure and staffing needs for the future. If we are to fully address the growing burden of disease in our country and province, we then need to decide on a tailor made model of health-care and platform for delivery as a matter of urgency.

Human Resource Development and Management

Honourable members’ health-care is a very dynamic and quite fragile sector. The market forces of supply and demand are forever at play and people on the receiving end are always the poor in the third and developing countries.

It is important to note that developing countries like ours invest far greater than developed countries on human resources development, but constantly remain with net deficiency in terms of supply of these resources. This also applies to private sector in our country.

We have concluded our Human Resources Plan which comprehensively addresses the issues of skill acquisition, training, development and retention.

As we reported previously, we now have a new organisational structure which allows us to take a long term view in terms of our human resources planning. We will procedurally implement the new structure by first identifying critical posts in the structure and finding funding streams for these new posts.

Honourable members our department will continue to offer bursaries to learners in our province as a medium to long term measure in addressing the skill deficit. We will equally continue with the Cuban training programme. Last year, 11 learners from our province were sent to Cuba to study medicine and we will be sending 20 more students this year.

Outcome Based Approach  

Honourable members, it is common cause that the ruling party-ANC- identified five priorities which will inform the business at hand of government in this term of office. Health is one of these priorities. Subsequently cabinet approved ten Medium Term Strategic Framework priorities informed by the ANC manifesto. Aligned to these priorities, the health sector developed a road map for health delivery which is now known as the Ten Point Plan. 

As a direct response to the new approach of service delivery health sector has identified 20 outcomes which are categorised in four broad interventions namely:

  1. Increasing life expectancy
  2. Combating HIV and AIDS
  3. Decreasing the burden of disease
  4. Improving health systems effectiveness

These outcomes are a direct response to our dire health challenges in the country namely:

  1. 1Life expectancy has drastically declined in our country and province
  2. Maternal mortality and child mortality remain excessively high
  3. There is huge burden of disease especially HIV; AIDS and TB
  4. We have a predominantly curative system of health rather than preventative approach
  5. We have generally poor delivery of health-care system

The central thrust of these outcomes, is a need to strengthen Primary Health-Care as a cornerstone for health-care service delivery and restore a preventative approach to health rather than the expensive, unsustainable and ineffective curative approach we are currently pursuing as a country.

Over the past 16 years, we have built numerous clinics and community health centres in our province, focusing mostly in rural areas which were historically underserved.

Part of our intention was not only to adhere to national norms that requires a person not to travel more than five kilometres to access a health facility, but more importantly our approach is premised on ensuring community based health-care delivery, thus reducing caseload in hospitals, which by design should deal with more complicated issues.

We are aware that there are many areas in our province which remain without static health facilities. It is in this context that we will strengthen our mobile services so that all our people can access health-care services in areas where they frequent and/or stay. I am also pleased with the partnerships we have established with NGOs especially in Gert Sibande District where they have donated mobile clinics to service farming communities.

Private sector has also contributed significantly in assisting with building clinics in areas of need. Last week I opened three clinics in Nkangala donated by Xstrata Mines.

Honourable members we cannot over-emphasise the importance of an efficient and effective referral system in the delivery of health-care in our province. It is not sustainable that our hospitals can accommodate all the people that by-pass clinics. On the other hand, we fully understand the push factors and we are working around the clock to address all these challenges which include drug shortages, staff shortages and short operating hours. We are about to finalise the referral policy which will guide and streamline our service package.

The other critical element of the functioning of our health-care service is a need for oversight at all levels; hence the National Health Act gave rise to establishment of Hospital Boards and Clinic Committees. Health facilities should be community based, and it is very important to all elected representatives to play critical oversight over their functioning. We have established Clinic Committees in almost all our clinics and will complete the establishment of Hospital Boards in the remaining hospitals before the end of the first quarter 2010.

Honourable members, the ANC health plan which has guided formulation of policy since 1994, prioritise four key areas of focus to transform health-care in our country; quality, access, equity and affordability. With regard to the quality aspect, we have established six key areas upon which facility managers are going to be measured against. These are:

  • Patient safety
  • Infection prevention and control
  • Availability of medicines
  • Cleanliness
  • Waiting times and caring attitudes of our employees 

To ensure that our health facilities adhere to these core standards, all of us, especially elected representatives, must play a critical role as I have mentioned earlier on.

We need to pressure the system from within, because the patience of our people is not elastic, and sooner or later they will revolt against the inferior service they get from our health facilities. 

I have consistently remarked that our people have unfortunately been made to feel as if they are being done a favour when they visit their own facilities. Many people who use our health facilities have no choice but to use them, and if they had alternative they would not use some of our facilities. We are indeed mindful that there are many men and women in our health facilities who are committed towards making a change and work very hard under very strenuous situations.

I want to share with this house an article extracted from DENOSA publication where one of our employees who is a member and shop steward of this union wrote and I quote:

“Colleagues, I am so saddened by the attitude of some of nurses out there. Patients are being humiliated day and night. What has gone wrong really? Have we forgotten our pledge when we joined nursing profession? The first line in the nurse’s pledge is that: I solemnly pledge myself to the service of humanity and will endeavour to practice my profession with conscience and with dignity”.

He continues

“Some nurses are unfortunately doing the opposite. Let us remember that patients are human beings and it is their constitutional right to be treated with respect and dignity.
Patients go to health facilities because they believe that we can make them better, so I plead with all nurses; let’s stop mistreating our patients. Let us give them the quality nursing care they deserve. The next time we encounter our patients let us restore our profession by executing our duties ethically”.

He further states:

“As nurses we are also human beings and we are not immune to stress. Let us avoid venting our anger and frustrations on innocent patients. We must seek professional advice whenever the need arises. A smile does the trick as it soothes the soul. I plead with all nurses to uphold the image of the profession. Let us remember that we are there to help nurses recover from their ailments and not to make them worse. He ends with a slogan; Phambili ngamanesi phambili”. 

Sipho Dlamini graces us with his presence today and may I want request him to take a bow. He is clearly providing leadership at his level and I hope the gospel can reach all labour unions and all our employees.

Over the Easter weekend, I personally visited all our hospitals and I did so at night. While this was a fact finding mission, at a strategic level it was also to provide content to a need as alluded earlier to pressurise the system from within, so that our employees should at all times know that they are being watched. My findings are not far away from the constant complaints we get from communities.

Health Promotion

Honourable members many of the diseases prevalent today are what we call diseases of lifestyle. They are by and large preventable. It is in this context that a central thrust of our approach is to encourage healthy living amongst our people.

To this end, and in facilitating this new approach, we have established 18 healthy lifestyle forums in the province especially at district and sub-district level.  The aim of these forums is to facilitate collaboration of the cluster departments towards the promotion of healthy lifestyles campaign as well as identify and implement effective and efficient interventions towards the promotion of this campaign focusing on promoting good nutrition, physical activity and safe sexual behaviour and combating the use and abuse of tobacco products, alcohol and substance abuse.

Further than this, we also want to mainstream this campaign into our schools so that children are taught at an early stage to look after their well-being.

In this regard, and in addition to the 209 health promoting schools in the province, another 30 schools will be established as health promoting schools bringing the total to 239 schools in the province.

Comprehensive HIV and AIDS Care, Management and Treatment

At the World Aids Day celebration last year, President Jacob Zuma announced ground breaking new measures in the fight against HIV and AIDS in our country. These new measures will see more people enrolled on the ART treatment at a much earlier disease stage, and these services will be available in almost all health facilities.

A fundamental point of departure in these new measures is a need to refocus our energies on more prevention measures while not neglecting the other equally important aspects of care, support and treatment.

To this end, a new drive for prevention which focuses on people knowing their status has been launched. We hope to test 15 million people by June 2011 and 1.1 million of these people will be tested in our province.

A critical element of this drive is a need to provide leadership at the highest level, and I must commend the exemplary leadership of our Premier DD Mabuza and some of my colleagues in the Executive Council who publicly tested during the launch of the campaign in our province in Lekwa Municipality on 30 April 2010.

Testing remains a personal commitment and voluntary. It provides a personal disclosure to each of us, from the moment of testing, we are afforded an opportunity take wiser decisions about our lives. We are going to roll out this campaign to reach all corners of our province.

During our provincial launch 742 people registered for testing of which 246 were males and 496 were females. Over 590 attended counselling and 566 were tested.

Our provincial HIV prevalence rate continues to be worryingly high, and has in fact increased from a year to year basis since 2006. We are currently standing at 35.5% and we remain the second highest after KwaZulu-Natal. Gert Sibande is one district that requires concerted effort before it reaches disastrous levels.  The prevalence rate in our districts is Gert Sibande at 40.5% Ehlanzeni 35% and Nkangala 31.9%.

Our biggest concern is that Gert Sibande is the fourth highest district in the whole country in terms of prevalence. We are working on a number of interventions and this will include a massive medical male circumcision programme that we will launch in the district.

In our drive to support and provide treatment to people infected with HIV at the end of March we had 70 064 people on the ART programmes and we plan to increase this number to 102 855 by the end of March 2011.

We will also increase our roll out sites from 34 to 114 in this financial year. The total budget for the ART programme in this financial year is R 271 million.

A critical element of care and support is the home based care approach. We will fund 150 Home Based Care organisations in this financial year and have budgeted R51million. 

Tuberculosis (TB)

Honourable Members, TB continues to cause havoc in that increasingly many people in South Africa die as result of TB infection. This is very worrisome especially considering that the disease is both preventable and curable.

Although we have made considerable progress in improving our TB cure rate from 60% to 63.4% year on year we still need to double our efforts to further improve on our cure rate. Of concern again is that we are witnessing about 2 000 new cases on an annual basis.

It should however be noted that this increase is partly due to heighten awareness and actually means that many people who might have long been infected are only presenting themselves to our facilities now, hence a need for continued awareness and community mobilisation.

We want to move our cure rate to 68% and reduce our defaulter rate from 8% to 7% in this financial year.  We will also strengthen our Direct Observation Therapy Support (DOTS) programme by enrolling 2 000 DOTS supporters.

We currently have 486 Multi Drug Resistance TB patients in our province and only 66 of these are hospitalised in our MDR TB hospital in eMalahleni. We have allocated R14million to support community based management of MDR patients.

To increase our capacity, construction of a 40 bedded MDR facility at Bongani TB hospital in Ehlanzeni will be completed at the end of December 2010 which will be funded by the Global Fund.

We must still work hard to remove stigma associated with TB so that all people can present themselves early in our health facilities for more effective treatment.


Malaria elimination is of high priority in the country and province. This in effect means that all strategies must be intensified in the fight against malaria.  Local malaria transmission must be reduced to zero by 2015. 

We will also focus on malaria case management and awareness to ensure that the malaria death rate is reduced.  We have also done extensive work in this area especially in preparations for the FIFA Soccer World Cup.  We should however make mention that it is fortunate that the games will be played during the malaria off season.

Nonetheless, we have not rested on our laurels and up to date sprayed over 18 000 rooms covering lodges and guest houses in the high risk areas of Bushbuckridge, Nkomazi, Umjindi and Mbombela.

We made commendable strides in the fight against malaria and increased our spray coverage rate from 91 % in 2008/09 to 92% in the 2009/10 financial years. Over 469 000 structures were sprayed covering Nkomazi, Bushbuckridge, Kruger National Park, Mbombela and Umjindi areas. With the indoor residual spraying programme malaria vector mosquitoes are killed and thus reduce malaria transmission.

It is quite regrettable Honourable members that we continue to loose lives due to malaria. We recorded 1 856 malaria cases in 2009/10 financial year with twenty one 21 deaths.

These deaths represent 1.13% fatality rate which is above the norm of 0.5%.

Our investigations revealed that contributing factors were late presentation of patients to health facilities, misdiagnosis by primary health-care facilities and delays in referrals to the next level of care. 

Mother and child health

Honourable members mother and child health forms one part of our Millennium Development Goals (MDGs) targets. They continue to provide the measure of how far as a country and province we have moved in ensuring that no mothers die due to complications associated with giving birth and that no children die in their infancy stage.

While there is still much work to be done, our province has shown a decline on  infant facility mortality rate over the years; in 2008/9 it was at 18.2% and we are  planning to reduce it further to 13.5% by the year 2015 contributing positively to the attainment of the MDGs .

The reduction can be indebted to the strategies that are being implemented in facilities on child health, like the Integrated Management of Childhood Illnesses (IMCI) strategy that is implemented in 97% of PHC facilities,

the Child Problem Identification Programme (Child PIP) that is implemented in 27 hospitals and the Integrated Maternal and Child Heath (MACH) project that is implemented in 10 Hospitals.

The Expanded Programme on Immunisation introduced the new vaccines to prevent morbidity and mortality from Pneumococcal Disease and Rotavirus disease during 2009. The National target that was set for coverage during 2009/10 was 40% and 60% during 2010/11 and 80% during 2011/12. We surpassed this target by reaching 69% for Pneumococcal vaccine and 61% for Rotavirus vaccine.

During the recent Measles outbreak we had 2 530 suspected measles cases and confirmed 827 cases. In order to mitigate the outbreak, the province is participating in a National Mass Immunisation campaign.

The first round of the integrated immunisation campaign for Polio/Measles/ H1N1 and Vitamin A started on 10 April 2010 and the second round will start on 22 to 30 May 2010.

Our maternal deaths in facilities have declined from 168.2/ 100 000 deliveries in 2008 to 156.8/ 100 000 in 2009. This number however remains high.

Intergrated Nutrition Programme

Honourable members nutrition is a critical component of our efforts to support people infected with HIV and TB. We will spend an amount of R16, 8 million which has been allocated to the procurement of nutrition supplements; targeted at people living with HIV/AIDS and Tuberculosis, as well as malnourished individuals

Our routine vitamin A supplementation coverage in children between 12 to 59 months is 32%, and we are working hard to improve the coverage at least for children under one to 80%. 

Communicable disease control

Honourable members will remember that in 2009 we were faced with the challenge of H1N1 Pandemic Influenza A (H1N1) outbreak. We were however very fortunate in that of the 500 confirmed cases in our province we recorded only one death compared to the other provinces. As a result and in response to the outbreak we took a decision that all pregnant women in their third trimester should be treated with Tami flu medication in all public health facilities.

To mitigate the effect of the pandemic in 2010, the department is embarking on influenza immunisation campaign to all selected risk groups. These are our front line health-care workers, children under 15 years on ARVs, children above 15 years, and adult on ARV, pregnant women, chronic patients with heart and lung diseases.

The contingency plan for 2010 FIFA World Cup has been developed and is in place. All necessary capacity building was conducted to Outbreak Response Teams to enable them to respond to any kind of outbreak. 

Eye Care Program

Honourable members this is one shining example of excellence in the department. We are very proud more so with the continuous partnerships with NGOs, such as the Bureau for the Prevention of Blindness, Nelspruit Lions Club and Ster Kinekor.

In the last financial year, we conducted 2 881 cataract operations, screened 92 715 people, refracted 16 265 patients and dispensed 8 385 spectacles. We have exceeded our targets in respect of screening, refraction and supplying of spectacles.

In this financial year, we will perform 3 600 Cataract operations, screen no less than 50 000 people for different eye conditions, conduct refraction tests for 15 000 people and dispense 5 000 free or subsidised spectacles.

Emergency Medical Services (EMS)

Honourable Speaker one of the programmes that will benefit from the legacy of FIFA Soccer World Cup is our EMS. This programme forms the backbone of our preparations for the FIFA games.

We have already in preparation for the games procured 101 emergency vehicles in the last financial year. These vehicles will be used for the 2010 FIFA World Cup and beyond. Furthermore 86 Emergency Care Practitioners were appointed during the year to decrease staff shortage.

The biggest breakthrough is the installation of the integrated computerised information system inclusive of the real time tracking of ambulances and digital radio communication system of which phase one is in progress. The furniture and medical equipment for Mbombela stadium has been delivered.

The department launched its state of readiness on 13 April 2010 at the Mbombela stadium. On the same day we showcased medical equipment, emergency vehicles, forensic vehicles, CDC, Malaria and HIV and AIDS initiatives hand in hand with our private sector partners.

Pharmaceutical services

Honourable Speaker, the effective function of our public  health-care system do not only depend on factors I have alluded to earlier which are personnel, infrastructure and technology, but of critical importance is availability of drugs and medicines in our health facilities.

The call we have made to our people to utilise clinics will remain a pipe dream as long as there is no consistent supply of drugs to these facilities.

In this regard, but also as an attempt to deal with some aspects of our challenges, we have already opened our new depot in Steve Tshwete Municipality after long delays. Once fully operational at its optimum level, it will assist to deal with administrative delays that have an impact on non availability of drugs and medicines in our facilities in general.

I have made this program my special focus in this financial year and I will introduce extra-ordinary measures if the need arise to resolve the problem of drug supply in the province.

Infrastructure and hospital revitilisation

Honourable members, public health sector is faced with huge challenges. We are not only faced with shortage of personnel which is a major input in our work, but also the aging infrastructure and technology. This reality has a huge potential to negate all attempts to transform public health sector into a viable and responsive sector.

Most of our health facilities were built ages ago and are inevitably not coping with the demands of our current situations.

Coupled with this, in the infancy of our democracy we focused mostly on building new health facilities thus neglecting maintenance of the existing ones, hence a huge backlog of maintenance in most of our facilities.

To this end, we will continue with our revitalisation program focusing more in the immediate future on completing many facilities which has long been on this programme. It has indeed been a thorn in our sides that these projects have taken this long to be completed. We are however delighted to announce that 3 major revitalisation programs in 3 major hospitals namely; Rob Ferreira, Ermelo and Themba hospitals are progressing very well and will be completed by the end of this financial year. 

We have already commenced by planning to put the following hospitals on the revitalisation programme; Tintswalo, Barberton, Lydenburg, KwaMhlanga, Mapulaneng, Middleburg and Witbank hospitals.

Of these hospitals we have already approved the business cases of three hospitals namely; Tintswalo, Barberton and Lydenburg. We are still awaiting approval of our business cases for the rest of hospitals.

As we mentioned earlier we intend to build a tertiary hospital in our province. We have already developed a business case and a health brief which has been submitted to the National Department of Health for appraisal. We are very excited by this prospects because of its potential opportunities for the public health sector in our province and it is our considered opinion that the acute shortage especially specialists we are experiencing will be a thing of the past once fully operational.  

The Department of Public Works, Roads and Transport is expected to assist with allocation of suitable land and it is envisaged that the tertiary hospital will be in close proximity with the university. In this financial year we will build five new Community Health Centres and one EMS station in the province. These facilities will be built in the following areas;

  • Hluvukani  in Bushbuckridge Local Municipality
  • Masibekela in Nkomazi Local Municipality
  • Mashishing In Thaba Chueu Local Municipality
  • Tekwane in Mbombela Local Municipalitywo
  • Wakkerstroom in Pixley Ka Seme Municipality
  • Emergency Medical Services Station in Moloto in the Thembisile Hani Local Municipality

We will also purchase two TB hospital buildings from SANTA in Barberton and Standerton.

We hope to complete the new Community Health Centre that is currently being built in Mbombela. Once completed, this facility will ease pressure from Rob Ferreira hospital, allowing this hospital to focus on its designated mandate.


Honourable speaker allow me to present to house the budget of the department for 2010/11 financial year and to further request the house to approve the budget.

The total budget of the department for 2010/11 financial year is R 6420 715 000 

Programe 1:

Administration: R328 134 000

The purpose of this program is to provide overall management of the department, and provide strategic planning, legislative and communication services and centralised administrative and financial support through the MEC’s office and administration.

Programme 2:

District Health Services: R3 086 330 000

The purpose of this program is to render comprehensive Primary Health-care Services to the community using the District Health System as a model.

Programme 3:

Emergency Medical Services: R223 819 000

The purpose of this program is to provide pre-hospital medical services, inter-hospital transfers, Rescue and Planned Patient Transport to all inhabitants of Mpumalanga Province within the national norms.

Programme 4:

Provincial Hospital Services: R761 616 000

The purpose of this programme is to render secondary health services in regional hospitals and to render TB specialised hospital services.                 

Programme 5:

Central Hospitals: R706 099 000

The purpose of this programme is to render secondary and tertiary health-care services and to provide a platform for training of health-care workers including research.

Programme 6:

Health Science and Training: R230 198 000

The purpose of this programme is to ensure the provision of skills development programmes in support of the attainment of the identified strategic objectives of the department.

Programme 7:

Health-care Support Services: R97 498 000

The purpose of this program is to improve the quality and access of health-care.

Programme 8:

Health Facilities Management: R730 021 000

The purpose of this programme is to build, upgrade. Renovate, rehabilitate and maintain facilities. 

Honourable Speaker in the course of our work, which is informed by our historical mission of creating a better life for all, we sometimes understandably become so hard on ourselves to even realise some milestones in our path. Of course it is because we have made our goal that we shall never enjoy any sleep for as long as there are so many people inflicted by the burden of disease, illiteracy, fear and want; hunger and poverty.

We become hard on ourselves for not achieving enough, although many countries commend our progress within such a short period. 

We shall continue to be hard on ourselves for we understand that ours is a historic mission which may not be achieved in our life time, but we derive energy and satisfaction from the knowledge that our fore bearers would not turn in their graves because they would be happy that the ideals for which they sacrificed their lives are slowly but surely being attained.

The road ahead will not be even, it will continue to be a rough landscape, but we know that together with the masses of South Africans who correctly understand that three hundred years of slavery and oppression shall never be over-turned in mere sixteen years. We appreciate their patience, and we commit to never take it for granted for we know it is not elastic. 

Allow me in conclusion to thank the Head of Department, Management and entire staff of the Department of Health for their dedication and commitment and to continue to keep their eyes on the ball.

I want also to pass my sincere appreciation to the sterling leadership and support of our Premier and colleagues in the Executive Council. I would further like to thank the Portfolio Committee for their continued critical oversight. 

Lastly I want to thank my family for their continued understanding and support. When we are not home or unable to spare anytime for them, they always understand that our family extends beyond them.

Kea Leboga.

Thank you.

Issued by: Department of Heallth, Mpumalanga Provincial Government

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